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Visual functions after photorefractive keratectomy.

1. 45 myopes (-3.0 to -6.0 D) were examined before and 1 and 6 months after photorefractive keratectomy (PRK). Visual acuity (VA) was tested using Snellen and logMAR charts. Contrast sensitivity (CS) was measured using a computerized system. 2. Preoperative best corrected VA (BCVA) in myopes was significantly lower in comparison with a control group using logMAR charts only. A reduction of BCVA by both methods at 1. month and its return after 6 months nearly to original values was noted. 3. Significantly lower values of CS were found in patients before PRK compared to the control group. After 1 and 6 months stayed the values on preoperative level.

Adult↗

The correlation of visual function with posterior retinal structure in severe retinopathy of prematurity. Cryotherapy for Retinopathy of Prematurity Cooperative Group.

The Multicenter Trial of Cryotherapy for Retinopathy of Prematurity previously reported reduced incidence of both poor structural and functional outcomes after cryotherapy. We compared the results in 304 eyes of patients in the randomized portion of the trial in whom both structural and functional assessments were performed 12 months after randomization. Two hundred fifty-five eyes (83.9%) had concordant outcomes: 153 eyes had favorable structural and functional outcomes and 102 eyes had unfavorable structural and functional outcomes. Twenty-nine eyes (9.5%) had discordant outcomes: 20 eyes had favorable structural and unfavorable functional outcomes and nine eyes had unfavorable structural and favorable functional outcomes. The small number of discordant outcomes could generally be accounted for by three factors: (1) retinal abnormalities beyond those considered in the photographic grading system (12 eyes), (2) nonretinal visual pathway disease (five eyes), or (3) false-positive and false-negative results in the measurement systems used to evaluate structure and function (five eyes). In 20 eyes (6.6%), photographs could not be graded or the visual acuity was untestable. We conclude that the appearance of the posterior pole of the eye correlates well with grating acuity in the 12-month-old infant with a history of severe retinopathy of prematurity.

Cryosurgery↗

The photostress recovery test in the clinical assessment of visual function.

To distinguish optic nerve conduction defects from macular disease in patients with otherwise unexplained loss of central vision we first determined the best visual acuity with correction at distance in unilateral defects. The normal eye was tested first and photostressed for ten seconds by looking at an ordinary penlight held 2 to 3 cm from the eye. The time required to read three letters on three Snellen test lines just larger than the best acuity was used as the end point. In 63 eyes with maculopathy the recovery time was prolonged. Prolonged recovery time was not observed in 20 patients who had optic nerve disease.

Diagnosis, Differential↗

Good visual function after neonatal surgery for congenital monocular cataracts.

We treated eight neonates who had total, monocular, congenital cataracts with surgery, occlusion, and contact lenses. Visual results in all eight patients were good. In five patients visual acuities improved to 6/9 (20/30) or better in the aphakic eye. In three patients visual acuities improved to 6/24 (20/80) or better. Problems with contact lenses probably accounted for the poorer results in two of these three patients. Binocularity was not demonstrated in any of our patients.

Aphakia, Postcataract↗

Comparison of visual function after foveal translocation with 360 degrees retinotomy and with scleral shortening in a patient with bilateral myopic neovascular maculopathy.

PURPOSE: To compare the visual outcome after foveal translocation by scleral shortening and that after 360 degrees retinotomy with extraocular muscle surgery in a patient with bilateral myopic neovascular maculopathy. METHODS: Case report. RESULTS: A 52-year-old woman with bilateral myopic neovascular maculopathy underwent foveal translocation with scleral shortening in the left eye, and visual acuity improved from 20/70 to 20/30. However, choroidal neovascularization recurred, and the final visual acuity was 20/40 after excision of the choroidal neovascularization. Foveal translocation with 360 degrees retinotomy was performed on the right eye, and visual acuity improved from 20/150 to 20/30. The critical print size was better, and the retinal sensitive area was larger in the right eye. CONCLUSION: The better reading ability shown by foveal translocation by a 360 degrees retinotomy compared with scleral shortening may stem from a larger retinal sensitive area obtained by this method.

Choroidal Neovascularization↗

Combined three-dimensional anisotropy contrast imaging and magnetoencephalography guidance to preserve visual function in a patient with an occipital lobe tumor.

OBJECTIVE: Three-dimensional anisotropy contrast (3-DAC) magnetic resonance imaging and magnetoencephalography (MEG) of visually evoked magnetic fields (VEFs) were used to accurately localize the optic radiation and primary visual cortex before surgery for an occipital tumor. PATIENT AND METHODS: A 26-year-old male presented with an occipital lobe tumor located intrinsically underneath the right calcarine fissure. 3-DAC imaging showed that the right optic radiation was located along the superior and lateral surfaces of the lesion. Mapping of the VEFs demonstrated that the primary visual cortex was located superior and lateral to the lesion. The lesion was totally resected via an infero-medial cortical incision using a frameless stereotactic system. Histopathology indicated a pilocytic astrocytoma. No visual deficit was found before or after surgery. CONCLUSION: Combined 3-DAC imaging and MEG can provide essential information about the optic radiation and primary visual cortex for planning the surgical treatment of occipital lobe tumors.

Adult↗

[Importance of n-3 and n-6 fatty acids for visual function and development in newborn infants].

Long-chain polyunsaturated n-3 and n-6 fatty acids are present in human milk, but not in the majority of infant formulas sold in Denmark. The content of the n-3 fatty acid DHA is high in retinal tissue and cerebral cortex. A number of studies have suggested that the content of DHA has a positive influence on the function of cell membranes. Preterm infants receiving human milk or infant formula with DHA have a better visual acuity than those receiving infant formula without DHA. In term infants receiving infant formula the content of DHA in plasma, red blood cell membranes and cerebral tissue is reduced compared to breast-fed infants.

Child Development↗

Retinal transplantation-induced recovery of retinotectal visual function in a rodent model of retinitis pigmentosa.

PURPOSE: To map the spatiotemporal decline in retinally driven activity in the superior colliculus (SC) of transgenic S334ter-line-3 rats that express a mutated rhodopsin, which causes photoreceptor degeneration. To determine whether transplantation of fetal retinal sheets into the subretinal space of these rats can recover visual activity in the SC. METHODS: A visual stimulus was presented to the eye, and responses were recorded across the SC of untreated S334ter-line-3 rats aged 28 to 288 days. These data were used to draw a map of the developing scotoma. Intact retinal sheets from embryonic day 19 rats were transplanted into the subretinal space of S334ter-line-3 rats between 21 and 28 days of age. Responses to retinal stimulation were mapped in the SC of transplanted and sham control rats 78 to 163 days after surgery. The morphology of the retinas in all groups was examined. RESULTS: Photoreceptor cell loss in untreated rats matched the decline in visual activity in the SC. At 28 days, there was a scotoma in the area of the SC that represents the central retina and, by 63 days, it had enlarged to cover the entire retinal representation. Visual responses were evoked in 64% of rats with retinal transplants. These retinally driven responses were confined to a small, contiguous region of the SC that represents the sector of the retina where the transplant was placed. Visual responses were absent in the SC outside this area in transplant recipients and throughout the SC of untreated and sham control rats. CONCLUSIONS: Transplantation of fetal retinal sheets induced recovery of visual activity in the SC in this model of RP. The mechanisms underlying this functional recovery remain to be resolved, but these results suggest that transplantation should be further explored as a therapy for RP.

Animals↗

Factors affecting the stability of visual function following cessation of occlusion therapy for amblyopia.

AIM: To identify factors that predict which children with amblyopia are at greatest risk of regression of visual acuity (VA) following the cessation of occlusion therapy. METHOD: A retrospective analysis was performed of 182 children (mean age at cessation of treatment; 5.9+/-1.6 years) who had undergone occlusion therapy for unilateral amblyopia, and had been followed up at least once within 15 months of cessation. Statistical analysis was used to identify whether change in VA following treatment cessation had any association with various factors, including the child's age, type of amblyopia, degree of anisometropia, initial severity of amblyopia, binocular vision status, length and dose of occlusion therapy, and VA response to treatment. RESULTS: At 1 year, follow-up from treatment cessation, children with "mixed" amblyopia (both anisometropia and strabismus) demonstrated significantly (p=0.03) greater deterioration in VA (0.11+/-0.11 log units) than children with only anisometropia (0.02+/-0.08 log units) or only strabismus (0.05+/-0.10 log units). However, none of the other factors investigated were found to be significant predictors. CONCLUSION: This study supports previous research that it is possible to identify those children most at risk of deterioration in VA following cessation of occlusion therapy. The presence of mixed amblyopia was the only risk factor identified in this study. Management of amblyopia should take this into account, with a more intensive follow-up recommended for those with both anisometropia and strabismus (mixed) amblyopia.

Amblyopia↗

Ultraviolet-induced lenticular fluorescence: intraocular straylight affecting visual function.

Ultraviolet radiation (UVR) excitation of fluorophores within the crystalline lens results in intraocular straylight. These fluorescent emissions are known to increase with age. The visual effect of this increase in fluorescent straylight has not previously been published. In this study, the visual deficit associated with UV-induced lenticular fluorescence was measured for 61 normal subjects between the ages of 21 and 80 yr of age using the Regan visual acuity charts at varying levels of contrast. UVR was shown to decrease low contrast acuity and this loss increased linearly with age.

Adult↗

[Preoperative electroretinogram for predicting postoperative visual function of vitrectomy].

Vitrectomy was performed on 17 patients [19 eyes] who had dense vitreal opacity and precluding inspection of the ocular fundus. The preoperative visual acuity was light perception to 0.1, the postoperative visual acuity was 0.03 to 0.9. The preoperative electroretinogram [ERG] was tested on all patients. The correlation of the amplitudes of the ERG b-wave to the postoperative visual acuities were statistically analysed. The results showed that there was positive correlation of the amplitude of the preoperative scotopic bright ERG b-wave to postoperative visual acuity [r = 0.7709, p less than 0.01], and positive correlation of the amplitude of the preoperative photopic ERG b-wave to the visual acuity [r = 0.8086, p less than 0.01]. It suggests that the bigger amplitude of the preoperative ERG b-wave was, the better postoperative visual acuity was improved. Thus, the preoperative ERG could predict the outcome of vitrectomy in various ocular diseases with vitreal opacities and very low visual acuity.

Adolescent↗

Studies of visual function and its decay in mice with hereditary retinal degeneration.

Functional implications of mouse hereditary retinal degeneration have been studied at the level of the superior colliculus and visual cortex in the C57BL/6J-le rd strain. On autoradiography at a light-microscopic level, following eye injection with radioactive compounds, central visual structures appeared normal. A slight reduction in ipsilateral retinal projection was probably related to reduced retinal pigmentation associated with the light ear (le) mutation. In recordings from visual cortex and tectum in rd mice older than five months the cells discharged with highly rhythmic maintained activity. This ongoing activity depended on retinal input, since temporary asphyxia of the eye stopped it immediately. The frequency of the rhythm was influenced by the anesthesia. In these older mice no visual receptive fields could be mapped, but in a few tectal recordings it was possible to suppress the maintained activity by diffuse, very intense illumination. As in normal mice, no auditory or somatosensory responses were observed in the visual cortex or upper tectal layers. In recordings from tectum before the age of three weeks retinotopic topography and receptive fields were normal. By day 24 no receptive fields could be recorded from parts of the tectum representing the central 90--100 degrees of the visual field, whereas within a peripheral ring responses were still roughly normal under photopic conditions. Over the following four months these peripheral responses faded away slowly. Incremental thresholds, especially in the scotopic range, were elevated, rising slowly to unmeasurable values. Similarly during dark adaptation the thresholds fell to values several log units above those reached in normal mice; these values of dark adapted thresholds in rd mice rose with age. This is consistent with morphological changes known to occur in the retina as a consequence, of the rd mutation the rods degenerating before the cones.

Animals↗